Editorial Page - James Dickie MD to join HCA

EXCITING NEWS We are excited to announce James Dickie MD will be joining the staff of Health Centers, full time, beginning february 1st of 2008. Dr. Dickie comes from family practice in Kansas to join in our practice of treating chronic illness. You will find Dr. Dickie a very caring, intelligent, willing to listen to patients, willing to learn, and most important, very trustworthy. More about Dr. Dickie within the next month.

EDITORIAL COMMENTS The following comments are not necessarily those of any of the physicians or staff of Health Centers of America but those of the Webmaster-Michael

Thinking Outside the Medical Box in other words, "Where did that good ol country doctor go"?

In the AMA news this week (March 2007), the following headline appeared, "Rethinking training in chronic disease management". The article went on to say, "At present, medical education is based on an acute care model in which patients are examined, diagnosed, treated and released," said David C. Thomas, MD at Mt. Sinai School of Medicine in New York. In the March issue of "Psychology Today" in an article on Morgellons disease, Rhonda Casey MD of Oklahoma State University Pediatric department says,"...the structure of modern medicine can discourage examination of complex, multisystemic disorders. Most doctors are still poorly prepared to address illnesses with both physical and psychological components." Robert Bransfield MD says in the same article "Your average physician does a one-month rotation in psychiatry in medical school,...so when there's a disorder that has physical and psychiatric symptoms, physicians often don't understand how to put all the pieces together....one way to think of it is that there's quite a bit of cross talk between the immune system and the nervous system...but thee isn't a lot of cross talk between psychiatrists and immunologists and infectious disease doctors. The way we've compartmentalized specialties contributes to our difficulty in dealing with problems like this." When diagnoses in this gray zone of understanding, they often end up on the field of mental health, he says, even when there's a solid physiological cause.

Webmaster's comments:It is becoming increasing clear the difficulty most doctors have in seeing a specific disease within the total framework of a persons disease processes. This has significant ramifications in two important areas of healthcare: 1)physicians who are ill trained, ill prepared, and often unwilling to diagnose and treat patients with chronic illness; 2)The insurance industry, government (Medicare, Medicaid, CDC, FDA) and the pharmaceutical industry are cutting costs (not paying for chronic illness} and limiting treatment options (pharmacy) for difficult to manage diseases. The article in "Psychology Today" went on to name what they call "Diseases Under Fire" meaning those diseases which most doctors do not understand. In addition to Morgellon's disease which the article was written about: • Chronic Fatigue Syndrome • Fibromyalgia • Chronic Lyme Disease • Multiple Chemical Sensitivity Syndrome • Gulf War Syndrome Of a side interest to many, in the same article, Ginger Savely, a Nurse Practitioner, sees an overlap of Morgellons patients and Lyme disease. Sevely says that 90 percent of her Morgellons patients tested positive for Lyme disease. Finally, a ray of hope for the greater medical community. The AMA reports that several medical schools are now receiving grants for programs training future physicians on how to treat chronic illnesses. That good ol country doctor, who many of us had the privilege to know, not only saw patients in his office and the hospital, but made house calls, was forced to see the entire picture of a patient's illness. He or she, was not only a physician who thought in terms of multisystems when it came to diseases (outside the box), but was forced to be a good psychologist as well. In Dr. Ryser's many slide presentations, she has the following two slides that are an appropriate closing. "The burden of Chronic Illness is staggering: It affects families, friends, communities, societies, and countries. The burden is physical, emotional, financial and spiritual. The clinician can experience a sense of being overwhelmed." Carol Ann Ryser MD “Our moral and ethical obligation as physicians, is to look at the health crises and evaluate how to structure our practice to address our chronic illness chaos for current and future generations” Carol Ann Ryser MD Later in the same slide a quote from William Osler MD, "“If you listen long enough, the patient will give you the answers.”